Provider Demographics
NPI:1255384897
Name:ESPINOZA, ANDREY (MD)
Entity type:Individual
Prefix:
First Name:ANDREY
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGHWAY 31 STE 101
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5811
Mailing Address - Country:US
Mailing Address - Phone:908-237-9092
Mailing Address - Fax:908-237-9095
Practice Address - Street 1:200 ROUTE 31 STE 101
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5811
Practice Address - Country:US
Practice Address - Phone:908-237-9092
Practice Address - Fax:908-237-9095
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07774300163WC3500X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0068535Medicaid
NJ0068535Medicaid
I08398Medicare UPIN